Transcript Ergonomics for Sonographers. An Owner`s Manual


Ergonomic Guidelines for Sonographers
CHECKLIST

Managing Work Injury Prevention in Sonography

The Importance of Ergonomics in Diagnostic Ultrasound

Setting up the Ergonomic Work Station

Sonographer Work Related Injuries

The Economics of Ergonomics for Sonography

The Importance of Exercise and Fitness In the Prevention of WRMSDs

Reducing Muscle Fatigue & Load Through Postural Changes

Making it Ergonomically Right with What You Have

Taking Responsibility for How you Practice

Reducing Your Risk of Occupational Injury

The injury risk factors impacted by chair
selection are…
› Increased spinal pressure
› Unsupported feet
› Decreased circulation of lower extremities

The study of ergonomics involves
adapting the work environment to the
worker, NOT adapting the worker to the
work environment.

Data collected from around the world
shows that over 80% of sonographers
have some degree of pain or injury
related to their work as a sonographer.
Of these individuals, 20 percent have
sustained a career-ending injury.

Sonographers at the highest risk for
developing MSD (musculoskeletal
Disease) are those who perform the
same type of exams during the work
day.

Engineering controls:
› The name for ergonomic controls that
remove or reduce the presence of risk
factors in the work place.

Once your patient is lying on the exam
table, ask her to move toward you and
close to the edge of the table. Adjust the
height of the table and chair so that your
forearm is PARALLE to the floor when
your elbow is bent at a 90-degree angle.

Symptoms of MSD can occur after
months or years of overuse and have
been
staged
according
to
the
reversibility and outcome of the
symptoms.

There are Three stages of pain: Stage 1,
Stage 2, and Stage 3.

Aching, fatigue and weakness, as well
as pain, describes Stage 1.

Specific disorders of MSD common
among sonographers are:
› Tendonitis
› Thoracic outlet syndrome
› De Quervain’s Syndrome
 Tendonitis of the sheath that surrounds the two
tendons that control movement of the thumb.
The cost to the employer of WRMSD
(work-related musculoskeletal disorder) is
significant. Of all the costs associated
with WRMSD, Worker’s Compensation is
the most costly.
Other costs-Replacement staff…
It takes more than one…
 Employers, Sonographers, and
Equipment Manufactures can contribute
to a reduction in WRMSD in Sonography.

Treatment for WRMSD has a poor
outcome because sonographers return
to
the
same
injury-producing
environment*.
*without modification.

In addition, many leisure activities can
cause MSD:
› Gardening
› Knitting
› Playing the violin
› Texting?
HINT: What to be published in the JDMS?
Run a study on texting and how it relates/does
not relate to MSD. GET A GRANT TO FUND
THIS STUDY!!
Add-on patients are best
accommodated during lunch breaks so
that the workday does not exceed 8
hours.
 NOT!!!
 Give yourself a chance to rest.



The term “ergonomics” was created by W.
Jastrezebowski in the 1800’s.
The International Ergonomics Association defines
ergonomics as follows:
“Ergonomics is the scientific discipline
concerned with the understanding of
interactions among humans and other
elements of a system, and the profession
that applies theory, principles, data and
methods to design in order to optimize
human well-being and overall system
performance.”
The SDMS (Society of Diagnostic Medical
Sonography) has sponsored several
activities that addresses ergonomics:
› Sonographer Benchmark Survey
› The 1997 sonographer survey by the
Healthcare Benefit Trust of British Columbia
› The consensus conference in May of 2003

The phases of ergonomic intervention in
the workplace include:
› Analysis of the worker’s job tasks
› Proposing possible solutions to mitigate
worker injury
› Regular evaluation of the effectiveness of
solutions

The OSHA (Occupational Safety and
Health Administration) regulation that
addresses
Sonography
work
environments is the General Duty Clause.
› “Each employer shall furnish to each of his
employees employment and a place of
employment which are free from recognized
hazards that are causing or are likely to
cause death or serious physical harm to his
employees.”

Changing a Sonographer’s work
schedule is an example of an
Administrative control measure.

Ergonomic training is an example of a
control measure called SONOGRAPHER
SOLUTIONS.

Best practices for sonographers:
› Adjusting chairs & exam tables
› Positioning patient close to worker
› Supporting scanning arm
› Performing regular stretching exercises
› STUDENTS!!!
 SEE NEXT SLIDE

A key factor that contributes to a
worker’s risk for MSDs is STRESS.

Factors that may reduce a worker’s risk
for MSDs are:
› Stretching
› Employer support
› Relaxation

Excessive trunk bending and twisting can
be prevented by
› Moving the patient close to the worker
› Adjusting the exam table height

Prolonged sitting results in Muscle
shortening.

Extreme and prolonged arm abduction
is injury producing because:
It decreases circulation to the shoulder
joint.

When sitting for prolonged periods of
time, movement is important for
› Maintaining hip flexibility
› Strengthening back muscles
› Strengthening abdominal muscles

Studies measuring force exerted by
sonographers during an exam show that
force can be as high as 40 lbs.

One way to reduced risk for injury
resulting from bedside exams is to
perform exams portably only when
absolutely necessary.

A more comfortable position for the
Sonographer's scanning arm during
endovaginal exams is with forearm
below shoulder level

Exam gloves can contribute to injury risk
unless:
› They fit properly
› They have textured finger

An example of the indirect costs
associated with worker injury is the cost
of hiring replacement staff.

Examples of the direct costs associated
with worker injury are:
› Cost for rotator cuff surgery
› Worker’s Compensation insurance
The main goal of ergonomics is to
increase productivity.

The ergonomic benefit of retractable
side rails on the exam table is to:
› Reduce the distance between the
sonographer & the patient.

An important dietary component for
maintaining muscle tone is Vitamin B

Upper body stability can be achieved by
good foot support.

Collectively, MSDs (or MSIs:
Musculoskeletal Injuries) are defined as
Injuries caused by work activities.

The economic impact of worker injury is
› Loss of experienced workers
› Loss of productivity
› Personal financial hardship

Exercise helps mitigate injury by
developing the muscles that support
neutral postures
Tendon injuries have an impact on the
surrounding muscles.
 The
Muscle must compensate by
providing increased support for the joint,
which can lead to further injury.

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Musculoskeletal pain can be caused by
damage to:
› Bones and joints,
› Muscles, and tendons,
› Ligaments, nerves and bursae

Early symptoms of WRMSK may occur at
night causing disruption of sleep

The components of the ultrasound work
station are:
› Ancillary equipment
› Personal adaptive equipment
› Ultrasound system

Cushions for forearm support, cable
brace are considered to be adaptive
equipment.
The following features are essential for
an ergonomic multipurpose ultrasound
table:
› Electrically height adjustment
› retractable side rails
› stirrups
› brakes
The major four sites of injury for the
Sonographer are:
› Shoulder,
› neck
› wrist
› Upper back
The most ergonomic work station would
have the following:
 Table height adjustable from 22-38
inches,
 Chair height adjustable from 17-38
inches.
 Ultrasound system with monitor
separately adjustable from the control
panel.

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Muscle activity be reduced by
supporting the forearm on cushions or
towels by as much as 78%.

Question: “How many scans is it ‘safe’ to
do per day?”

Answer: “It is not how many exams you
can do, but how you scan that reduces
your risk.”